In the 1995 American Thyroid Association (ATA) guidelines, biological and synthetic thyroid hormone preparations containing T4 plus T3 were not recommended out of concern for fluctuating and often elevated serum T3 concentrations (71). In conjunction with the American Association of Clinical Endocrinologists in 2012, the ATA continued to recommend l-thyroxine monotherapy and noted that evidence does not support using synthetic combination therapies; in addition, they stated that “desiccated thyroid hormone should not be used for the treatment of hypothyroidism” (72). In 2014, the ATA recommendations evolved with the recognition that 1) serum T3 levels might not be normalized in all l-thyroxine–treated hypothyroid patients and 2) some patients remain symptomatic while receiving l-thyroxine monotherapy. Titration of l-thyroxine dose to achieve normal TSH concentrations remains a first-line approach, but trials with combination therapy can be considered. In addition, the guidelines recognize that although superiority data are lacking, some patients do experience a clinical response with desiccated thyroid preparations or combination therapy with l-thyroxine plus l-triiodothyronine (1). The European Thyroid Association has similar recommendations (2).
l-Thyroxine monotherapy, the novel and physiologically savvy method for treatment of hypothyroidism, contrasted with the traditional approach of natural thyroid preparations that was marred by potency concerns. In less than a decade, there was a major shift in treatment of hypothyroidism such that normalization of TSH with l-thyroxine monotherapy became the new standard of care (Appendix Table) (52). Many clinicians advocated for this to be first-line therapy and for patients previously treated with desiccated thyroid to be transitioned to l-thyroxine monotherapy (50).

I was concerned about an ongoing “mental fog” and forgetfulness I had – which is one of the symptoms of Hashimoto’s. I was having trouble losing weight and also felt very low in energy. Since following Dr. Osansky’s recommendations I have found that I have a greater sense of calm – something I didn’t expect from the treatment and changes in diet and lifestyle. In addition to getting my Hashimoto’s under control, I have enjoyed other health benefits as well. I no longer suffer from anemia, my Vitamin D levels are normal and my immune system is strong. My thyroid blood tests also improved. Although it’s a commitment and initial expense, it is completely worth it in the long run. Given the alternative (taking thyroid medication for the rest of your life), in my opinion it’s a no brainer. If you give a natural treatment protocol a fair chance you’d be surprised at how much more empowered you’ll feel about your illness and treating it. A natural treatment protocol is an effective solution that puts you in the driver’s seat when it comes to your health. Traditional methods do the exact opposite.


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The purpose of treating hypothyroidism is to maintain normal metabolism by correcting a deficient output of thyroid hormone. Once replacement therapy begins, the thyroid will stop producing hormones all together, and replacement must be continued for life. Most mainstream physicians prescribe the drug Synthroid, also known as levothyroxine, a synthetic analog of thyroxine (T-4) and monitor how much to give based on symptoms and levels of TSH. Physicians will generally check TSH levels after a couple of months of being on the medication and adjust it accordingly. They will often used a more cautious course in patients who have cardiovascular disease. This allows the heart time to adjust to an artificially increased metabolism. Side effects of taking too much thyroid hormone include shakiness, palpitations, insomnia and changes in appetite.
Gluten is a protein found in wheat, rye, and barley. Unless you've been diagnosed with celiac disease, it probably won’t affect your thyroid. Gluten can damage the small intestines of people with celiac disease. They can have other autoimmune disorders like Hashimoto’s disease (which leads to an underactive thyroid) and Graves' disease (which leads to an overactive thyroid). If you have celiac disease, a gluten-free diet may help prevent these thyroid diseases.
If you are diagnosed with hypothyroidism, it may sound horrible, but you could be in it for life. This means you'll need to change your diet and lifestyle entirely. There must be a conscious and consistent plan for your everyday intake of food to prevent flares of symptoms that could disrupt your everyday routine. If you adhere strongly to your diet plan, then there shouldn't be any worries about symptom attacks later on.

Those with hypothyroidism may want to consider minimizing their intake of gluten, a protein found in foods processed from wheat, barley, rye, and other grains, says Ruth Frechman, RDN, a dietitian in the Los Angeles area and a spokesperson for the Academy of Nutrition and Dietetics. And if you have been diagnosed with celiac disease, gluten can irritate the small intestine, and may hamper absorption of thyroid hormone replacement medication.

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